Provider Demographics
NPI:1659783306
Name:CLICKACLINIC COM INC
Entity Type:Organization
Organization Name:CLICKACLINIC COM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BENTVENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-8500
Mailing Address - Street 1:6252 S CONGRESS AVE
Mailing Address - Street 2:SUITE J1,2
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-2352
Mailing Address - Country:US
Mailing Address - Phone:561-601-1290
Mailing Address - Fax:561-641-6821
Practice Address - Street 1:6252 S CONGRESS AVE
Practice Address - Street 2:SUITE J1,2
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2352
Practice Address - Country:US
Practice Address - Phone:561-601-1290
Practice Address - Fax:561-641-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC10231OtherAHCA